More attentive to health issues

It is not a coincidence or part of a conspiracy that a growing number of media practitioners have been talking, writing or bringing focus on public health issues and policies. They are not targeting the DOH, PhilHealth or any official for that matter.

The fact is, just like the general population, the key opinion leaders in Philippine media fall under the “fast aging population.” While economists and propagandists are busy stating that the country is in a good place because of its young and growing population, many of us in media are in the “senior citizen” category. 

This is when you come to terms with ailments, disease and physical deterioration which, in turn, lead you to doctors, hospitals and fellow patients with regularity. As you wait for the often-late MD, you meet Filipinos experiencing the assorted ailments that come with age or payback for unhealthy living. During these unintended meet ups, you learn the good and the bad stories about medicine and public health. 

If you happen to attend gatherings, chances are, right after the initial updates of status and profession, the conversation will unavoidably turn into a comparison of medical conditions, impromptu presentation of signs and symptoms and “who paid the highest professional fee and hospital bill.”

As always, the medical updates spread like aftershocks of an atomic bomb and soon people are talking about what happened to an apo, a kasambahay or an in-law. Add to the mix the accessibility of Dr. Google and information overload occurs.

 And so, I counsel our health practitioners and officials to rest easy. Media does not have your face on a bullseye or your office on a hit list. But we are now more aware of and sensitive to medical issues or concerns because we are now the suffering patients or the paying parent, grandparent or employer for medical treatments and services.

 Given the readily available information provided on the internet as well as the shared actual experiences, we no longer sit quietly accepting a prognosis or doctor’s findings. We no longer stay away from the science and complexity of public health or the practice of medicine. Our personal experiences and the cost or consequence of medical practice to our lives have made it all the more personal. 

One or two generations ago, Filipinos had no choice in terms of treatment and no opinion on the matter, you simply took your doctor’s word. But given how Filipinos have traveled more than at any time in history and how we have learned about getting a second, third, even a fourth opinion on prognosis and costs, technology and travel has given Filipinos a real choice.

I know of friends who now travel to Thailand and Cambodia for actual medical procedures and executive check-ups and not just cosmetic surgery, lifts or tucks. In Bangkok, I frequently saw non-Thai young women with nose shields while being tourists. When I ask friends why they go to other countries, everything always goes back to the cost difference. 

A couple shared that going to a hospital in the region was far more practical as well as discreet. When they checked on the total cost of travel and medical treatments, it was like a two-in-one package that gave you treatments and going on a vacation at the same time.

 The local hospital did not see $$$ signs just because they were foreigners and did not care if they were somebody or nobody. There were no hidden costs or exorbitant professional fees, just very good service. 

In terms of public health policies and directions, officials and policy makers in the Philippines have to realize that the world has become so much smaller and information and shared knowledge is literally at everyone’s fingertips via smart phones.

 Government health experts and political appointees can carry on believing they know what’s best because they have the title or the position, but many such characters have drowned in the wave of public opinion and globally shared information, as well as statistics. All it takes is a wrong move or bad attitude and you’re doomed.

 The major concerns that are being talked about now are the high cost of treatment, unregulated and unaffordable professional fees, hospitalization stays that are comparable to what hotels charge and extended confinements.

 Then there are the treatment options where surgery is the preferred option. Pity the women who have had their womb scraped needlessly, elderly undergoing unnecessary cataract procedures or renal failure patients placed on hemostatic dialysis instead of peritoneal dialysis, which is the more cost-effective option.

 Hemodialysis is machine-based filtering during renal or kidney failure affecting 55,000 Filipinos. Peritoneal dialysis “uses the peritoneum in a person’s abdomen to remove toxins during kidney failure. Peritoneal dialysis has better outcomes than hemodialysis during the first couple of years, allows movement and is better tolerated by patients with heart disease” (Wikipedia).

 Hemodialysis costs about double per treatment (P5,200/per treatment), requires a certified nephrologist to be on board and requires patients to be on site where the machines are. Peritoneal dialysis can be done by the patient or caregiver who is properly trained on PD. And it allows the patient to move around.

 As a result, promoting hemodialysis costs patients more and so they don’t complete the number of required treatments, cost PhilHealth P17 billion in 2022 and turned the construction of local and national dialysis centers into a profitable industry nationwide.

Making medicine affordable and accessible, putting up more hospitals and training more qualified health workers should be the priority, not politics or making pogi points with PBBM or enabling profit driven treatment facilities.